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Y6 Passmed > Imperial Formatives and Past Papers > Flashcards

Imperial Formatives and Past Papers Flashcards

1
Q

How do you differentiate PMR from autoimm arthritides

A

PMR stiffness takes A LOT LONGER to improve in the monring (2-3 hours)

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2
Q

how do you manage PMR

A

PREDNISOLONE

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3
Q

whhat must you check if suspecting a carbon monoxide poisoning

A

check CARBOXYHAEMOGLOBIN

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4
Q

what drugs must patients with mechanical valves be on

A

WARFARIN and ASPIRIN

NOT DOACs yet !!!

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5
Q

what can trigger psoriasis

A 
TRAUMA (skin injury) 
alcohol 
drugs (lithium, beta blockers, antimalarials, NSAIDS, ACEI) 
withdrawals of steroids 
Infection
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6
Q

what infection triggers guttate psoriasis

A

STREP

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7
Q

whicih airway device protects against aspiration

A

ENDO TRACHEAL TUBE

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8
Q

what other type of mass in the testis transilluminates that is not a hydrocoele, and how does it present differently

A

EPIDIDIMAL CYSTS also transilluminate (because fluid filled)

aka spermatocoele (they are the same thing!)

cysts do NOT surround the testis (unlike hydrocoeles)
- they are well defined and you can GET ABOVE THEM

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9
Q

how should you measure MG respiiratory failure

A

FVC <1L

negative inspiratory force (NIF) < 20 cm H2O

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10
Q

what is first line antipsychotic for delirium

A

HALOPERIDOL (PO >if refuse, IM)

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11
Q

when is haloperidol contraindicatedd

A

if Parkinsons disese, ECG abnormalities

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12
Q

what must you five when haloperidol is contraaindicated

A

give LORAZEPAM instead

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13
Q

when do you NOT need to give anything for suspected tetanus wound?

A

if last VACCINE dose <10 years ago

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14
Q

what do you need to give in high risk tetanus wound with vaccine more than 10 years ago

A

if tetanus prone: reinforce vaccine dose
if very HIGH risk: reinforce vaccine dose + tetanus IVIG

(treat like this if you are unsure of tetanus vaccine status)

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15
Q

what feature on urine MCS is suggestive of contamination

A

mixed bacterial growth

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16
Q

what can commonly precipitate lithium toxicity

A

DEHYDRATION (e.g. due to diarrhoea and vomiting)

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17
Q

what is opening pressure like in bacterial men

A

HIGH

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18
Q

what is opening pressure like in viral men

A

NORMAL

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19
Q

first line reccomended ix for renal stones

A

unenhanced CT KUB

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20
Q

when must you stop an ACE i

A

STOP when creatinine increases by MORE THAN %30 over the first two months

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21
Q

how do you investigate a vestibular schwannoma (or any concerning cause of tintinnus / hearing loss to exclude this)

A

with an MRI

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22
Q

how does catapexy present

A

loss of skeletal muscle tone with strong (happy) emotions

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23
Q

what is second line for OA (after paracet / topical NSAID)

A

oral NSAID + PPI

OR

weak opioid

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24
Q

which virus causes tonsillar adenocarcinoma

A

HPV

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25
Q

what are risk factors for tonsillar adenocarcinoma

A

HPV
smoking
alcohol

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26
Q

what is first line mx for DCIS breast cancer (unless >4cm)

A

Wide local excision (for cancers <4cm)

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27
Q

when is colectomy reccomended for UC

A

when there is EPITHELIAL DYSPLASIA

because this means there is a high risk of mutating to cancer

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28
Q

what do red cell casts suggest

A

NephrITIC syndrome

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29
Q

what do brown granular casts suggest

A

ATN

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30
Q

what is the difference on LP between viral meningitis and encephalitis

A

NO DIFFERENCE

they both only have slightly raised lymphoocytes

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31
Q

so how do you tell the difference betweel viral men and enceph

A

encephalitis will have seizures, more focal neuro degficits, altered mental state

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32
Q

describe the presentation of PSORIATIC ARTHRITIS in detail

A
  • Psoriasis
  • Nail POSh
  • Enthesitis (incl sacroilitis)
  • Dactylitis (swollen fingers)
  • Arthritis (asymmetrical, DIPJ affected, asthtiris mutilans, SPINAL ARTHRITIS)
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33
Q

what type of arthritis presents with DIPJ pain and back pain?

A

PSORIATIC

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34
Q

what is the most common arrythmia and cause of death after MI?

A

Ventricular FIBRILLATION

35
Q

what bad thing could myelodysplasia become?

A

AML (1/3)

36
Q

how does PCP show up on CXR

A

may be normal

or may present as bilat interstitial infiltrates / perihilar haziness

37
Q

nail change in hyperthyroidism

A

onycholysis

38
Q

which bacterium causing bloody diarrhoea is comma shaped / curved gram -ve rod

A

Campylobacter jejuni

39
Q

what does an enlarged mediastinum om CXR indicate

A

aortic dissection

40
Q

which tachyarrythmia does prolonged QT suggest

A

VT

41
Q

what does a positive McMurray’s indicate

A

a TORN meniscus

42
Q

where does BCC spread to

A

it doesn’t - LOCAL INVASION ONLY

43
Q

whar do FLOATERS + SUDDEN LOSS OF VISION SUGGEST

A

Retinal detachment

44
Q

in graves disease what causes exopthalmos (EYE BULGING OUT)?

A

Thickening of the rectal muscle

45
Q

what is the most common benign solid renal lesion

A

Angiomyolipoma

46
Q

if on asthma on inhaler therapy, what causes painful swallow?

A

the steroid e.g. betamethasone

as it causes candidiasis

47
Q

which neuropathic pain drug causes urinary retention

A

amiltyptiline

48
Q

electrolytic imbalances in TLS

A

HIGH potassium, urate, phosphate

Low calcium and mg

49
Q

effect of HYPOkalaemia on muscles

A

twitching, cramps

50
Q

what do you do to metformin before surgery in well pateitn

A

if BD: take as normal

if TDS: omit lunch dose

51
Q

what do you do with sulphonylurea before surgery in well pt

A

if OD: omit

if BD: take afternoon dose only

52
Q

when do you need to start insulin sliding scale before surgery in diabetic pt

A

if poor contol of DM HbA1c >69
T2DM and missing more than 1 meal and BM >12
Emergency surg

53
Q

which epicondilytis is LATERAL, causing pain on wrist EXTENNSION?

A

Tennis epicondylitis

54
Q

which artery is affected in LAT MEDULLARY SYNDROME

A

PICA

Posterior inferior cerebellar artery

55
Q

which investigation is diagnostic for Sjogren

A

biopsy

56
Q

mx alk spond

A

Physio

NSAID > NSAID > anti-TNFalpha (e.g. etanercep) or infiximab

57
Q

what advice can you give to pt on inhaled beclometasone experiencing oral candidiasis

A

stop smoking
rinse mouth after using
spacer

58
Q

what is the oonly first line abx for UTI in pregnant women, except for at term?

A

nitrofurantoin!

59
Q

second line abx for pregnant women with UTI

A

cefalexin

amoxicillin

60
Q

who do you need to fill out an advanced request for

A

for patients who WILL LOSE CAPACITY

61
Q

what is the BIGGEST RF for adenocarcinoma of the oesophagus

A

Barrett’s

62
Q

what is the pathophysiology of dupytrens contnracture

A

thickened palmar fascia

63
Q

what is costoconndritis

A

inflammation of cartilage in the aterior chest wall

64
Q

sx costochondritis

A

pleuritic chest pain

pain on palpation of chest

65
Q

what is a chylothorax

A

lymphatic fluid leaked into pleural space

milky white

66
Q

what causes chylothorax

A

surgery

cancer

67
Q

Most common side effect of radiotherapy for SCC lung cancer

A

oesophagitis

68
Q

hepatocell carcinoma marker

A

AFP

69
Q

which screening test can you use for malnutrition

A

MUST Malnutrition Universal Screen Tool

it takes into account BMI, recent weight change and the presence of acute disease

70
Q

how do you treat SC compression caused by mets

A

if non-frail, few lesions: surgical decom

if frail: dexamethasone PO/IV + radiotherapy

71
Q

what test investigates sleep disorders (i.e. people who keep falling asleep in daytime )

A

Polysomnography (incl narcolepsy, OSA)

72
Q

which bacterium causes pneumonia in CF pt

A

pseudomonas aeroginosa

73
Q
  1. Blood supply to 2nd part of duodenum
A

gastroduodenal artery

74
Q

how do you calculate alcohol units

A

Volume x ABV / 1000

75
Q

how do you manage a necrotic neuropathic ulcer

A

sharp debridement

76
Q

whic cancer has keratin pearls

A

SCC

77
Q

what type of pleural effusion does a PE cause

A

EXHUDATIVE

78
Q

what is the preferred antithyroid drug in pregnancy

A

PROPILTHIOURACIL

carbimazole is teratogenic

79
Q

what disease causes Colon biopsy showed caseous necrosis and Langerhans histiocytes

A

TB

80
Q

what kind of renal disease does SLE cause

A

NEPHRITIC (blood, protein in urine)

81
Q

how do you manage COPD pt with low sats if If the saturation remains below 88% in prehospital care despite a 28% Venturi mask

A

Change to nasal cannulae at 2– 6 L/min or a simple face mask at 5 L/min with target saturation of 88–92% and alert the emergency department that the patient is to be treated as a high priority.

82
Q

what diet do you use for IBS

A

FODMAP diet

83
Q

what does the FODMAP diet involve

A

stop eating certain foods,
reitroduce slowly

Dairy-based milk, yogurt and ice cream
Wheat-based products such as cereal, bread and crackers
Beans and lentils
Some vegetables, such as artichokes, asparagus, onions and garlic
Some fruits, such as apples, cherries, pears and peaches

Y6 Passmed (8 decks)

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